Protective effect of 3-aminobenzamide,an inhibitor of poly (ADP-ribose) synthetase,against streptozotocin-induced diabetes

Summary The addition of 3-aminobenzamide (a potent inhibitor of poly(ADP-ribose)synthetase) into the incubation medium, prevents streptozotocin-induced inhibition of glucose-stimulated insulin release from isolated islets [control 142±14U·islet^–1·h^–1; streptozotocin (0.5mg/ml) 31±8; 3-aminobenzamide (l.0 mg/ml) 96±11; streptozotocin plus 3-aminobenzamide 122±19]. In vivo, intraperitoneal 3-aminobenzamide 300 mg/kg body weight prevents the appearance of overt diabetes in streptozotocin-treated rats. These protective effects of 3-aminobenzamide are dose-dependent and are similar to those exerted by nicotinamide. Taking into account that poly ADP-ribosylation is involved in the repair of damaged DNA, the protection exerted by 3-aminobenzamide against the diabetogenic effect of streptozotocin strongly supports the view that this acute effect may be a major consequence of the activation of DNA repair mechanisms in islet cells.     

Ketogenic Diet as a Preventive and Supportive Care for COVID-19 Patients

Severe obesity is associated with an increased risk of admission to intensive care units and need for invasive mechanical ventilation in patients with COVID-19. The association of obesity and COVID-19 prognosis may be related to many different factors, such as chronic systemic inflammation, the predisposition to severe respiratory conditions and viral infections. The ketogenic diet is an approach that can be extremely effective in reducing body weight and visceral fat in the short term, preserving the lean mass and reducing systemic inflammation. Therefore, it is a precious preventive measure for severely obese people and may be considered as an adjuvant therapy for patients with respiratory compromise.     

Endoscopic third ventriculostomy versus ventriculoperitoneal shunt in pediatric and adult population: a systematic review and meta-analysis

Neurosurgical Review - Treatment options for hydrocephalus include endoscopic third ventriculostomy (ETV) and ventriculoperitoneal shunt (VPS). Some ambiguity remains regarding indications, safety,...     

The Use of Oral Amino-Bisphosphonates and Coronavirus Disease 2019 (COVID-19) Outcomes

The determinants of the susceptibility to severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection and severe coronavirus disease 2019 (COVID-19) manifestations are yet not fully understood. Amino-bisphosphonates (N-BPs) have anti-inflammatory properties and have been shown to reduce the incidence of lower respiratory infections, cardiovascular events, and cancer. We conducted a population-based retrospective observational cohort study with the primary objective of determining if oral N-BPs treatment can play a role in the susceptibility to development of severe COVID-19. Administrative International Classification of Diseases, Ninth Revision, Clinical ModificationI (ICD-9-CM) and anatomical-therapeutic chemical (ATC) code data, representative of Italian population (9% sample of the overall population), were analyzed. Oral N-BPs (mainly alendronate and risedronate) were included in the analysis, zoledronic acid was excluded because of the low number of patients at risk. Incidence of COVID-19 hospitalization was 12.32 (95% confidence interval [CI], 9.61–15.04) and 11.55 (95% CI, 8.91–14.20), of intensive care unit (ICU) utilization because of COVID-19 was 1.25 (95% CI, 0.38–2.11) and 1.42 (95% CI, 0.49–2.36), and of all-cause death was 4.06 (95% CI, 2.50–5.61) and 3.96 (95% CI, 2.41–5.51) for oral N-BPs users and nonusers, respectively. Sensitivity analyses that excluded patients with prevalent vertebral or hip fragility fractures and without concomitant glucocorticoid treatment yielded similar results. In conclusion, we found that the incidence of COVID-19 hospitalization, intensive care unit (ICU) utilization, and COVID-19 potentially related mortality were similar in N-BPs–treated and nontreated subjects. Similar results were found in N-BPs versus other anti-osteoporotic drugs. We provide real-life data on the safety of oral N-BPs in terms of severe COVID-19 risk on a population-based cohort. Our results do not support the hypothesis that oral N-BPs can prevent COVID-19 infection and/or severe COVID-19; however, they do not seem to increase the risk. © 2021 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).     

Changes in the transmural distribution of antioxidant enzyme activities across the left ventricle heart wall from rats fed ad libitum or food-restricted during growth and aging

Data on vulnerability to injury and on the larger age-related accumulation of lipofuscin in the subendocardial myocardium prompted us to investigate the changes in the levels and in the transmural distribution of catalase (C), glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) activities across the left ventricle heart wall of rats fed ad libitum a standard diet or submitted to intermittent feeding during growth and aging. Enzyme activities were assayed by standard techniques on subepicardial, midmyocardial or subendo- cardial tissue obtained by cutting the heart wall into 100-microm-thick sections at the cryostat. The levels of GSH-Px and of C (but not of SOD) activity increased with age and reached their highest values in the subendocardial region by adulthood or senescence, respectively. No effect was observed of intermittent feeding on age-related changes in enzyme levels and transmural distribution.     

Effects of capsaicin,tachykinins, calcitonin gene-related peptide and bradykinin in the pig iris sphincter muscle

Summary Capsaicin-sensitive sensory neurons of the rabbit iris, by releasing tachykinins, exert a major role in the control of pupil motility in response to various noxious stimuli. However, the contribution of sensory innervation to the regulation of iris smooth muscle tone in other mammals species is not known. We have studied the effects produced by electrical field stimulation, capsaicin, substance P, neurokinin A, calcitonin gene-related peptide (CGRP), and bradykinin in the isolated iris sphincter muscle of the pig.Capsaicin (10 M): a) contracted the isolated sphincter muscle and; b) released immunoreactivity for substance P (SP-LI) and CGRP (CGRP-LI) from this preparation. These two effects were no longer observed at the second exposure to the drug. Electrical field stimulation (10 Hz, 60 V, 0.5 ms for 5 s) produced a biphasic contractile response. The rapid component was inhibited by atropine (1 M), while the delayed response was blocked by previous exposure to capsaicin (10 M).Substance P and neurokinin A consistently produced contraction of the pig iris sphincter muscle, substance P being more potent than neurokinin A. CGRP induced a contractile response in more than 50% of the preparations. The tachykinin antagonist [D-Argl, D-Trp^7,9, Leu¹¹-substance P (3 M) blocked: a) the effect of substance P (1 nM); b) the delayed response to electrical field stimulation and; c) reduced by more than 50% response to capsaicin. Bradykinin (10 M) failed to release either SP-LI or CGRP-LI. The contractile response evoked by bradykinin was unaffected by in vitro pretreatment with capsaicin (10 M).The existence in the pig iris of capsaicin-sensitive sensory fibres releasing neuropeptides and thus regulating sphincter muscle tone is proposed. Send offprint requests to Dr. P. Geppetti at the above address     

Surgery: Adenomyosis at hysterectomy: a study on frequency distribution and patient characteristics

To evaluate the prevalence and risk factors for adenomyosis,the clinical records of consecutive women undergoing hysterectomyduring a 3 year period were retrieved. Data were collected onindication for the intervention, general sociodemographic characteristicsof the patients, age at menarche, parity, abortions, and menopausalstatus at surgery. Adenomyosis was diagnosed in 332 of the 1334cases (24.9%). The condition was present in 146 of the 627 patients(23.3%) with fibroids and menorrhagia, 68 of the 265 (25.7%)with prolapse, 21 of the 98 (21.4%) with ovarian cysts, 19 ofthe 100 (19%) with cervical cancer, 31 of the 110 (28.2%) withendometrial cancer, 16 of the 57 (28.1%) with ovarian cancer,and 19 of the 77 (24.7%) with miscellaneous indications. Thesedifferences were not statistically significant (x²₆ = 11.14).In comparison with nulliparous women, the odds ratio was 1.3and 1.5 respectively in women with one and two births (x²₁ trend= 5.76, P < 0.05). No relationship was found between ageat surgery, age at menarche, indications for surgery, menopausalstatus at intervention, and presence of endometriosis. Our findingsdo not support the notion that adenomyosis is more frequentlyrelated to particular clinical conditions, and suggest thatparity may be associated with an increased frequency of adenomyosis.     

Propagation of impulses in the guinea-pig ureter and its blockade by calcitonin gene-related peptide (CGRP)

The guinea-pig ureter was placed in a three-compartment organ bath to enable the application of electrical stimuli or drugs to its renal end (R site), the middle region (M-site) or the bladder end (B-site) while recording mechanical activity at the R- and B-sites. All experiments were performed in ureters pre-exposed to capsaicin (10 M for 15 min) to prevent the release of sensory neuropeptides from afferent nerves. Electrical field stimulation (EFS, 5–25 ms pulse width, 20 V) produced a phasic contraction at the site of stimulation (direct response to EFS) which propagated to the other end of the ureter. Section of the ureter at the M-site abolished the propagated response to EFS; after section, EFS applied at the M-site induced a phasic contraction at both the R-and B-sites. Likewise, the application of KCl at the M-site produced phasic contractions at both the R- and B-sites. Tetrodotoxin (1 M), nifedipine (1 M) or Bay K 8644 (1 M) applied at the M-site had no influence on the direct or propagated responses to EFS; nifedipine (10 M) applied at the M-site abolished the propagated responses without affecting the direct responses to EFS. Bay K 8644 (1 M) applied at the R-site produced a marked enhancement of the direct response (EFS applied at R-site) while having no effect on the amplitude of the propagated response to EFS. Nifedipine (1 M), applied at the R-site, produced a graded, time-dependent, inhibition of the direct response (EFS applied at R-site) and eventually suppressed it; the propagated response was unaffected until suppression of the direct response, when an allor-none blockade of the propagated response was observed. When applied at the B-site (EFS at Rsite), 1 M nifedipine produced a graded, time-dependent, inhibition of the propagated response and eventually suppressed it, without affecting the direct response to EFS. For further pharmacological analysis of drug action on the propagated activity, EFS was applied at the R-site and drugs were applied at the M-site. Human CGRP (CGRP, 0.1 M) or cromakalim (1-3 M) were applied in superfusion at the M-site in the absence or presence of glibenclamide (1 M). Neither drug affected the direct response to EFS; both CGRP and cromakalim produced a reversible suppression of the propagated response. Glibenclamide suppressed the inhibitory activity of 1 M cromakalim and partly antagonized the effect of CGRP; the blockade by glibenclamide was partly overcome by 3 M cromakalim. The present findings are consistent with the idea that propagation of excitation occurs because of the spread of electrical activity between smooth muscle cells of the ureter and that conduction of impulses is independent of local changes in contractility. The present results also demonstrate that CGRP induced a conduction block along the ureter and that this effect involves activation of glibenclamide-sensitive K channels. Therefore, a local release of CGRP in response to pathophysiological stimuli is, in principle, capable of suppressing ureteral peristalsis and antiperistalsis.     

Descending thoracic aortobifemoral bypass: an alternative approach for difficult aortic revascularization

Descending thoracic aortobifemoral bypass is an alternative inflow operation in cases in which standard aortobifemoral or axillobifemoral bypass is not an option. We performed descending thoracic aortobifemoral bypass for failed inflow operations in four patients, prior abdominal/pelvic radiation in two patients, poor quality distal aorta (extensive atherosclerotic disease or poor tissue quality) in two patients, and abdominal sepsis in two patients. Eight have had excellent results with patency at a mean follow-up of 38 months. There was no limb loss. One patient died of organ failure, and one patient with hypercoagulability developed a graft clot. A literature review disclosed that a descending thoracic aortobifemoral bypass was reported to have been performed in 203 patients, with most cases reported in the last decade. This procedure was the primary inflow operation in 42 per cent of cases. Indications for the operation included failed aortic grafts (38%), "hostile" abdomen (21%), infected aortic grafts (18%), and other (23%). The patency rate was 95 per cent at 6 months. Few long-term results are known, but the results appear to be durable. Descending thoracic aortobifemoral bypass is a useful operation in highly selected circumstances in which conventional methods of aortic reconstruction are not available.